Spring plate for fixation of comminuted posterior wall acetabular fractures

Introduction: Comminuted posterior wall acetabular fractures always remain difficult and challenging to assemble and stabilize with surgical management without any intraoperative or postoperative complications and satisfactory functional outcomes. Hence, correct selection of implant and correct technique are always key steps in the surgical management of comminuted posterior wall fractures of the acetabulum. Methods: We performed a retrospective observational study on 16 patients that were operated between July 2016 and December 2017 at Patna Medical College and Hospital, Patna. Medical reports of all patients with comminuted posterior wall fractures operated with locally crafted spring plates placed under 3.5 mm pelvic reconstruction plates were evaluated radiographically and with the past Harris Hip Scores (HHSs). Results: The average follow-up was of 15.8 months, and there were no occurrences of implant migration, loss of reduction, or joint incongruity. One patient had developed a superficial infection that was treated with dressings and oral antibiotics. Two patients had preoperative sciatic nerve palsy, which improved gradually over the course of 3 months. No instances of hip arthrosis or osteonecrosis were found. Thirteen patients scored excellent, whereas three scored good on the past HHS records. Conclusion: Our study strongly supports the concept that locally crafted spring plates placed under 3.5 mm pelvic reconstruction plates are a good fixation strategy in the management of comminuted posterior wall acetabular fractures.